Apologizing for medical errors may not stop you from being sued

Physicians who apologized and accepted responsibility for medical errors received better ratings and earned greater trust from patients than physicians who did not, a new study says. But such disclosures do not guarantee that patients won't still sue.

Researchers said their study in the September Journal of General Internal Medicine supports previous findings on apologies and disclosure of adverse events. But they were surprised to find that the patient's perception of what was said may be more important than what the physician actually said.

"One interpretation is that just because we think we've conveyed a message does not mean that it will be heard and understood," the study's authors said.

Researchers showed 200 volunteers from Baltimore videotaped vignettes depicting physicians disclosing one of three adverse events to patients (link).

The events were: a year-long delay in noticing a malignant-looking lesion on a mammogram; a slow response to pages by a pediatric surgeon for a patient who eventually is rushed to emergency surgery; and a chemotherapy dose 10 times the intended amount.

The extent of a physician's apology and acceptance of responsibility varied by vignette, from full apology to no apology. Viewers were asked to evaluate the doctors.

"Viewers were more likely to want to sue physicians who offered an incomplete apology or who did not accept responsibility," said study lead author Albert Wu, MD, MPH, a professor in the department of health policy and management at the Johns Hopkins Bloomberg School of Public Health. "When viewers thought that the doctor had apologized and taken responsibility, they gave the doctors much higher ratings, with 81% of viewers reporting trusting the physician and 56% reporting they would refer the physician."

What can physicians do to ensure that patients understand them?

Doctors who disclose an error should make sure the patient knows that the physician really regrets it, according to the study. Physicians also should ask questions to help ensure that their message gets through to patients. The study is available online (link).